Request Medical Records - Godfather Docs LLC

Efficient Scanning and Delivery

Our team utilizes today's technology to schedule appointments at designated locations, preform the work on-site and process copies for fast and efficient copy services.

Customer Satisfaction

Our number one priority is to complete your records request timely and efficiently. We understand the need and urgency of getting the job done, so we'll work diligently to complete the job in full.

Track Orders

Our client portal is coming soon. Track orders, log notes, view request copies, download records and more!

Request Type

WCAB Request

Civil Request

Personal Injury

If you have multiple requests please fill out separate forms

Delivery Options

RUSH

Pagination

CD / Electronic

Select all that apply

Due Date

Use yyyy-mm-dd format in Safari and Internet Explorer

Client/Applicant

Name

AKA

Case Number

Date of Birth

Use yyyy-mm-dd format in Safari and Internet Explorer

SSN

Date of Injury

Use yyyy-mm-dd format in Safari and Internet Explorer

CT Date of Injury

Employer/Insured

Name

Address

City

State

Zip Code

Phone

Fax

Requestor

Requestor Name

Attorney

Firm

Address

City

State

Zip Code

Insurance Information

Requestor

Carrier

Adjuster

Address

City

State

Zip Code

Phone

Fax

Claim#

Address(es)

Please indicate the location, address and phone number of the records.

Codes

Please indicate the Type of records to copy using the codes below.

[M]edical - [B]illing - [X]-ray Films - [E]mployment - [W]age - [C]laim File - [O]ther______________

Code